DESCRIPTION: (Applicant's Abstract) This R25 application responds to PA-96-042. Within the next few years, The Human Genome Project will lead to new and powerful tests, technologies and therapies. Medical students must be prepared for the ethical, legal, and social implications (ELSI) of this research. We propose to develop, evaluate, and implement an Internet-based education program specifically written for future physicians, today's medical students. We propose to teach medical students about ELSL issues related to genetics, especially genetic testing and counseling. We will create a module of six lessons that will be available on the Internet for medical students to take at the request of a course director. Each lesson will utilize a clinical-case scenario approach and will include straightforward clinical scenarios involving patients and genetic ELSI issues. Each lesson will be completed individually via the Internet; however students will be able to communicate among themselves as well as with the course director via the educational module. We will cover: 1) informed consent prior to testing, 2) providing genetics information to the patient that s/he can understand, 3) being non-directive, 4) how to work with families rather than just individuals, 5) how genetics can affect discussion of issues related to reproduction, and 6) understanding the repercussions of genetic testing. Other important ELSI issues will be interwoven into the above lessons including issues related to confidentiality of genetic information, provider bias, and conflict of interest. As necessary, each lesson will include basic discussions of molecular genetics, emerging technologies and research findings. A multidisciplinary team composed of a psychiatrist, a geneticist, a medical educator, and an anthropologist will integrate the views of genetics researchers with those of practicing genetic counselors, and medical students to create the content. We will evaluate the module's effect on attitudes toward counseling patients, clinical practice, self-efficacy, knowledge, and awareness of resources. A randomized study will compare subjects using the genetics module to subjects using a module on a topic that does not contain genetics information. Clinical practice changes will be measured using interviews with simulated patients who are trained to bring up ELSI issues related to genetics and genetic testing. After the value of the courses has been scientifically demonstrated we will work with medical schools throughout the United States interested in adding the ELSI genetics module to their curriculum. If successful, the training will expand the capabilities of medical students and prepare them for the genetics-related challenges they will face as practicing physicians.